Review article
Current Therapeutic Strategy in Inflammatory Bowel Diseases: The Importance of Mucosal Healing
Boris Vucelić
; KBC Zagreb
Abstract
Inflammatory bowel diseases, particularly Crohn’s disease, are characterized by intermittent clinical course, where each relapse leads to additional bowel injuries with resultant complications and the need for frequent hospitalisations and surgeries. Our current therapeutic strategy is therefore to apply an accelerated step-up approach. This approach consist in an obligatory early introduction of most efficient drugs in order to achieve early control of destructive inflammatory processes and thereby prevent their complications. A key to the achievement of a long and stable remission is mucosal healing, which is defined as endoscopic remission with absence of mucosal ulcerations. Although mucosal healing is only the initial event, it is critical in the suppression of inflammation in deeper layers of the bowel wall. This paper describes the mechanisms of mucosal healing and evaluates the ability of presently available drugs to induce mucosal healing. Many questions remain open like timing of discontinuation of biological therapy and development of new drugs with alternative mechanisms of action, so important for patients who are primary non-responders to anti-TNF therapy.
Keywords
inflammatory bowel diseases; mucosal healing; therapeutic strategy
Hrčak ID:
101972
URI
Publication date:
18.4.2013.
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